Original articleGeneral thoracicPrediction of Prognosis and Surgical Indications for Pulmonary Metastasectomy From Colorectal Cancer
Section snippets
Patients
A total of 75 patients with primary colorectal cancer, including 38 colon cancers and 37 rectal cancers, had pulmonary metastases excised from 1986 to 2003 at the Department of Thoracic Surgery, Chiba University Hospital (Chiba, Japan); patients were followed up through the end of 2004. Our criteria for resection of pulmonary metastases from colorectal carcinoma included unilateral or bilateral excisable lung lesions per preoperative chest radiography, no local recurrence of primary lesions,
Survival and Univariate Analysis
Overall 5-year and 10-year survival rates were 41.3% and 35.2% from date of pulmonary excision, respectively. Overall 5- and 10-year survival rates were 73.1% and 40.3% from date of primary colorectal resection, respectively (Fig 1). For overall survival after pulmonary resection, three prognostic factors were determined as significant by univariate p value: CEA, p < 0.0001 (Fig 2); tumor laterality, p = 0.0205; and number of pulmonary metastases, p = 0.0028; log-rank test (Table 1). For
Comment
The first and second target organs for metastatic colorectal cancer are the liver or lung. No report has disclosed any data from a well-planned randomized control study comparing surgery and other therapeutic procedures for pulmonary metastasis from colorectal cancer. The reason we selected surgery for these patients is that no effective chemotherapy has been established. Recently, we have encountered many cases of pulmonary metastases from colorectal cancer because of early screening with
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